Xantogranulomatozowe zapalenie nerek - choroba „wielki imitator”

In this article we show etiopathogenesis, clinical symptomatology and usefulness of medical imaging in diagnosis of very seldom form of tubularinterstitial nephritis known as xanthogranulomatous pyelonephritis (XGP). The characteristic feature of this disease is progressive destruction of renal parenchyma and perirenal tissues with following development of xantogranulomatosis tissue. What is decisive in the diagnosis is finding of inflammatory infiltration in xanthoma cells being laden with fat macrophages. The lack of typical clinical symptoms and very difficult for interpretation ultrasonographic and tomography pictures, imitating carcinoma processes, are the reasons for the delay of diagnosis. Recommended treatment is nephrectomy of the kidney with an inflammatory condition and, in cases of existing secretory function, decapsulation and heminephrectomy. Surgical treatment should be combined with broad-spectrum antibiotic therapy.